Vitiligo is painless and benign. The goal of treatment is to restore pigment to your skin, which is cosmetic. Treating vitiligo is a long-term commitment. Most therapies don’t show results for several months. Treatments include the following:
Steroids
Topical medications can be effective ways to repigment the white patches of skin. Topical steroid medications are used in children and adults. Steroids must be applied to the skin daily for at least three months before you can expect to see results. Steroid creams can have some adverse effects, including a thinning of the skin or streaks of color on the skin.
Immunomodulators
Another group of drugs called immunomodulators may also treat vitiligo. These are ointments that contain the active ingredient tacrolimus or pimecrolimus. According to the Mayo Clinic, people who have small areas of pigment loss on the face and neck usually see results with immunomodulators.
Ultraviolet Light
Ultraviolet light therapy can restore pigment in some people with vitiligo. Most often, you are required to take a medication called psoralen, which causes the skin to be more sensitive to the light treatment. Psoralen is available in both topical and oral forms. The combination of psoralen and UVA rays is called PUVA treatment. It darkens the light areas of your skin.
Since you’re more sensitive to sunlight when using psoralen, you should protect the rest of your body with sunscreen. You can get PUVA treatment several times per week in your doctor’s office.
Depigmentation
When repigmentation of the white patches fails, depigmenting the rest of your body is another treatment option. Depigmentation is reserved for those who present with vitiligo on more than half of their body. The goal is to match your normal pigmented skin to the areas affected by vitiligo.
A medication called monobenzone is applied to your skin to lighten the pigmented areas. This topical medication can bleach the skin of other people who may come into direct contact with you. Therefore, skin-to-skin contact must be avoided for two hours after treatment.
Noninvasive management of vitiligo can include makeup and sunless tanners. Tanning doesn’t help restore pigment loss from vitiligo, according to the NIAMS. Tanning makes the difference between normal and depigmented skin tone more obvious. You should use sunscreen with UVA and UVB protection to protect your skin.
Surgery Options
In severe cases, you may elect to have surgery to try to restore normal skin tone. Skin grafting takes healthy skin and places it in an area that has been affected by vitiligo. Such surgical procedures are possibilities for people whose vitiligo hasn’t improved despite several years of consistent treatment. The surgery is expensive, rarely covered by insurance, and can cause scarring.
